What Is NTM lung disease?

Water droplet containing aerosolized NTM bacteria

NTM lung disease is a serious infection caused by bacteria that are common in the environment and can cause lung damage.

Unlike tuberculosis, all forms of NTM, including the most common form, MAC lung disease, are not contagious. The bacteria are aerosolized, which means they can exist in water and soil particles that are in the air. People can get NTM lung disease when they breathe in the bacteria.

Everyone comes into contact with NTM bacteria during their daily lives. However, not everyone is at risk of getting NTM lung disease. Those with underlying lung conditions like bronchiectasis, COPD, and asthma are at greater risk.

Are MAC and NTM the same thing?

80% MAC on clipboard

There are many types of NTM lung disease. MAC lung disease is caused by a type of NTM bacteria called Mycobacterium avium complex, and is the most common species. It accounts for 80% of all NTM lung disease cases in the US.

Lungs with NTM bacteria inside

All forms of NTM lung disease, including MAC lung disease, can cause symptoms like chronic cough, fatigue, and shortness of breath. Even if you don’t have symptoms, this type of infection can have a lasting impact on your health by causing permanent damage to your lungs over time.

Some other types of NTM include:

M abscessus [ab-sess-ess]
M kansasii [can-zays-ee-eye]
M malmoense [mal-mow-ense]
M szulgai [sool-guy]
M xenopi [zen-no-pie]
Shedding light on NTM video will help you learn about adult NTM causes


Shedding light on NTM: Nontuberculous mycobacterial lung disease

Nontuberculous mycobacteria or NTM are invisible to the naked eye but are common in the environment.

People may come in contact with NTM in soil, tap water, steam in tubs, and in showerheads.

Most people do not develop NTM lung disease because their lungs are healthy enough to clear the bacteria; but people with a history of bronchiectasis, COPD, or asthma are at risk because their conditions make it difficult to clear NTM from the lungs.

Women and individuals aged 65 and older, as well as people with compromised immune systems also have a greater risk of NTM lung infection.

When NTM bacteria are inhaled, they can affect the damaged areas of the lungs and hide inside the body’s immune cells called macrophages.

NTM disable the defenses of macrophages, allowing the bacteria to multiply inside the body.

Common NTM lung disease symptoms which include coughing, shortness of breath and fatigue can worsen over time. And if not treated, can cause lung damage. To prevent NTM from causing serious and permanent lung damage, early diagnosis and appropriate treatment are important. If you suspect that you may have NTM, see your healthcare provider.

For more information about NTM, please visit aboutntm.com.

How Do You Get NTM?

NTM bacteria are common in the environment. People can come into contact with the bacteria through simple, daily activities, such as showering or gardening.

The bacteria can be found in places such as:

Adult NTM causes: Tap water with NTM bacteria

Tap water

Adult NTM causes: Showerheads with NTM bacteria


Adult NTM causes: Steam with NTM bacteria

Steam from
tubs and showers

Adult NTM causes: Dishwashing mist with NTM bacteria

Mist from the water
used to wash dishes

Adult NTM causes: Soil with NTM bacteria

Soil from parks, gardens,
and environment

About NTM: NTM bacteria were in 8 out of 10 water samples

One study across 25 states showed that NTM bacteria were found in nearly 8 out of 10 water samples.

How To recognize the symptoms

The symptoms of NTM lung disease are similar to other lung conditions. So similar, in fact, that NTM is sometimes misdiagnosed or not diagnosed at all. Many people have symptoms but may think it’s due to a lung condition they already have. People can have NTM for months, sometimes years, without knowing it.

If you live with a lung condition, like bronchiectasis, COPD, or asthma, you know what your symptoms typically feel like. So how can you tell if it’s NTM and not just your current lung condition acting up?

Well, the truth is, it’s very difficult. However, NTM lung disease has key symptoms that often get worse over time and don’t go away. For example, your cough can get worse, you can feel out of breath easily, and you can feel tired often—like your “get up and go” got up and went. These symptoms could be a sign that you have NTM lung disease. You may notice these symptoms come and go. You may have them every day. Each case of NTM is different.

If you have NTM lung disease, you may experience one or several of these common signs and symptoms. Click each one to learn more:


Adult NTM symptom: Coughing

It may be a chronic cough that you can’t get rid of, like a “coughing fit” or a cough that comes and goes. You may have a cough that:

  • is dry
  • brings up mucus
  • keeps you up at night
  • brings up blood

If you are coughing up blood, call or visit your doctor right away


Adult NTM symptom: Shortness of breath

When everyday activities, like walking your dog or climbing stairs, leave you short of breath, with a wheeze, or with tightness in your chest

Feeling Tired

Adult NTM symptom: ZZZ (being tired all the time)

Feeling tired or exhausted often, making it hard to do daily activities

Weight loss and/or
lack of appetite


Sudden, unexplained weight loss and/or not feeling like eating



A slight fever that
may also include night sweats and chills


NTM bacteria with circular arrows indicating recurrence

If you keep getting
a lung infection
or pneumonia

Symptoms that do not get better despite medicine

NTM medicine bottle

You may have taken medications for other lung conditions over a long period of time. But despite taking medicine, you keep getting sick

If these sound like you, talk to your doctor about whether or not you should get tested for NTM lung disease.

Worsening symptoms

If you have a lung condition, NTM bacteria can aggravate it. This can cause harm to your lungs over time. Worsening symptoms may also be a sign that you have an NTM infection. That’s why it’s important to get checked by your doctor if you feel your symptoms are not going away or are getting worse.

Red triangle with exclamation point

and NTM:
Your symptoms, like a cough, may get worse, and you could find yourself using airway clearance techniques more often

If you have
You may experience more flare-ups, difficulty breathing, and have a harder time catching your breath

If you have
You may experience more flare-ups and have a much harder time catching your breath

Does it sound like you could have NTM lung disease? People like you have shared their stories in hopes of spreading more awareness about this disease.

Watch real people tell their stories